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Tool parameters to minimize temperature changes in bone drilling

Published:January 03, 2023DOI:https://doi.org/10.1016/j.injury.2023.01.018

      Highlights

      • Increasing tool speeds while drilling into the osteochondral area of bone leads to an increase in temperature.
      • Increasing drill bit sizes while drilling into the osteochondral area of bone leads to an increase in temperature.
      • Drilling in bone can lead to an increase in temperature that can cause osteonecrosis and cell damage.

      Abstract

      Background

      Drilling is a common technique used in orthopedic surgery procedures but causes increases in temperature that can lead to cell damage and death. The extent of this depends largely on the magnitude of the increase in temperature. The commonly accepted limit to prevent osteonecrosis is less than 47 °C for 60 s. There is controversy when it comes to the optimal drilling parameters that limit temperature increases and cell death. In addition to this, less research has been done on the drilling effects in the osteochondral area of joints. Osteochondral tissue damage can interfere with the daily lives of patients and if severe enough will need to be treated. We hypothesize that increasing tool speed and drill bit size will increase temperature that could be above the osteonecrosis limit.

      Methods

      Ex-vivo experiments were conducted on porcine shoulder joints that tested the thermal effects of different tool speeds and drill bit sizes. A thermal camera was used to record and measure real time temperature changes while drilling. Three drill bit sizes and five tool speeds were used. Statistical analyses includes Welch's ANOVA with Games-Howell Post Hoc analyses, multivariate linear regression, and surface response regression were used to explore the association of tool speeds and drill bit size on temperature.

      Results and Conclusions

      All the tool speed and drill bit size combinations lead to an increase in temperature that were under the commonly accepted limit. The highest temperature reached was 44 °C with a tool speed of 1150 RPM and 3070 RPM and drill bit size 5.159 mm. It was found that increasing the tool speed increased the temperature change and increasing the drill bit size increased the temperature change.

      Keywords

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      References

        • Mediouni M.
        • Kucklick T.
        • Poncet S.
        • Madiouni R.
        • Abouaomar A.
        • Madry H.
        • et al.
        An overview of thermal necrosis: present and future.
        Curr Med Res Opin. 2019; 35 (Sep): 1555-1562
        • Shu L.
        • Bai W.
        • Shimada T.
        • Ying Z.
        • Li S.
        • Sugita N
        Thermographic assessment of heat-induced cellular damage during orthopedic surgery.
        Med Eng Phys. 2020; 83 (2020/09/01/): 100-105
        • Augustin G.
        • Zigman T.
        • Davila S.
        • Udilljak T.
        • Staroveski T.
        • Brezak D.
        • et al.
        Cortical bone drilling and thermal osteonecrosis.
        Clin Biomech. 2012; 27 (2012/05/01/): 313-325
        • Lee J.
        • Chavez C.L.
        • Park J
        Parameters affecting mechanical and thermal responses in bone drilling: a review.
        J Biomech. 2018; 71 (Apr 11): 4-21
        • Pandey R.K.
        • Panda S.S
        Drilling of bone: a comprehensive review.
        J Clin Orthop Trauma. 2013; 4 (Mar): 15-30
        • Augustin G.
        • Davila S.
        • Mihoci K.
        • Udiljak T.
        • Vedrina D.S.
        • Antabak A
        Thermal osteonecrosis and bone drilling parameters revisited.
        Arch Orthop Trauma Surg. 2008; 128 (Jan): 71-77
        • Bertollo N.
        • Milne H.R.
        • Ellis L.P.
        • Stephens P.C.
        • Gillies R.M.
        • Walsh W.R
        A comparison of the thermal properties of 2- and 3-fluted drills and the effects on bone cell viability and screw pull-out strength in an ovine model.
        Clin Biomech (Bristol, Avon). 2010; 25 (Jul): 613-617
        • Houston D.A.
        • Amin A.K.
        • White T.O.
        • Smith I.D.
        • Hall A.C
        Chondrocyte death after drilling and articular screw insertion in a bovine model.
        Osteoarthritis Cartilage. 2013; 21 (May): 721-729
        • Jamil M.
        • Rafique S.
        • Khan A.M.
        • Hegab H.
        • Mia M.
        • Gupta M.K.
        • et al.
        Comprehensive analysis on orthopedic drilling: a state-of-the-art review.
        Proc Inst Mech Eng H. 2020; 234 (Jun): 537-561
        • Farhan-Alanie M.M.
        • Hall A.C
        Temperature changes and chondrocyte death during drilling in a bovine cartilage model and chondroprotection by modified irrigation solutions.
        Int Orthop. 2014; 38 (Nov): 2407-2412
        • Brophy R.H.
        • Wojahn R.D.
        • Lamplot J.D
        Cartilage restoration techniques for the patellofemoral joint.
        JAAOS - J Am Acad Orthopaed Surg. 2017; 25: 321-329
        • Howard T.A.
        • Murray I.R.
        • Amin A.K.
        • Simpson A.H.
        • Hall A.C
        Damage control articular surgery: maintaining chondrocyte health and minimising iatrogenic injury.
        Injury. 2020; (May;51 Suppl-S9): S83